Clinical aspects of cervical insufficiency

Fetal loss is a painful experience. A history of second or early third trimester fetal loss, after painless dilatation of the cervix, prolapse or rupture of the membranes, and expulsion of a live fetus despite minimal uterine activity, is characteristic for cervical insufficiency. In such cases the risk of recurrence is high, and a policy of prophylactic cerclage may be safer than one of serial cervical length measurements followed by cerclage, tocolysis and bed rest in case of cervical shortening or dilatation. In low risk cases, however, prophylactic cerclage is not useful. There is a need for more basic knowledge of cervical ripening, objective assessment of cervical visco-elastic properties, and randomized controlled trials of technical aspects of cervical cerclage (e.g. suturing technique)

Quality assessments of untreated and washed quinoa (Chenopodium quinoa) seeds based on histlogical and foaming capacity investigations

Quinoa seed has a high nutritional value, but has a coating of bitter-tasting saponins, making it unpalatable. Therefore the seeds are usually processed in order to remove the naturally occurring saponins from the seeds. To investigate the impact of processing, untreated and washed seeds of the white and brown types of quinoa were investigated histologically and by foaming capacity evaluations. Reference samples of known origin and treatment were investigated as well as unknown samples. The results revealed a relationship between the presence of saponin containing papillose cells at the outermost layer of the seed hull in the histological sections and the foaming capacity of the seeds. After washing, the papillose cells were severely damaged or completely removed and virtually no foam formation was observed. This investigation indicatedthat washing resulted in an effective removal of the saponin layer, leading to quality improvement of the seeds intended for human and animal consumption. The same features were observed for the unknown samples. These results imply that the treatment of the investigated samples was based on washing. The determination of the type of treatment applied provided useful information for the correct tax classification for Custom purposes

Novel Magnetic and Thermodynamic Properties of Thiospinel Compound CuCrZrS4_{4}

We have carried out dc magnetic susceptibility, magnetization and specific heat measurements on thiospinel CuCrZrS$_{4}$. Below $T_{\rm C}^{*} =$ 58 K, dc magnetic susceptibility and magnetization data show ferromagnetic behavior with a small spontaneous magnetization 0.27 $\mu_{\rm B}/$f. u.. In dc magnetic susceptibility, large and weak irreversibilities are observed below $T_{\rm f} =$ 6 K and in the range $T_{\rm f}< T < T_{\rm C}^{*}$ respectively. We found that there is no anomaly as a peak or step in the specific heat at $T_{\rm C}^{*}$.Comment: 11 pages, 4 figure

Exercise in pregnancy : an experimental study of maternal and fetal responses to exercise in sheep

Pregnant women in the western world usually reduce their physical activity as term approaches. However, in recent years increasing numbers of women also voluntarily engage in relatively strenuous exercise during pregnancy. Both pregnancy and physical activity increase the body's metabolic demands, but the physiologic adaptations to these combined demands are only partially understood. On the one hand, one would expect adverse maternal or fetal effects because of the seemingly conflicting demands of the acutely exercising muscles and of the pregnant uterus. On the other hand, however, nature presents several examples in which strenuous physical activity during pregnancy co-exists with a favorable outcome of pregnancy. Therefore, further investigation of the adaptations to exercise in pregnant individuals is important from the viewpoint of physiology as well as of obstetrics. The study of the physiologic effects of exercise during pregnancy is complicated for several reasons. These include 1) large baseline changes within each individual during the course of gestation, 2) wide variation in baseline values between individuals (e.g., physical condition), 3) many differences in exercise load and/or experimental design between studies, 4) wide normal variation in fetal outcome, 5) possible interference off ear and other "stresses", 6) relative inaccessability of the fetus, 7) ethical and legal problems relative to studies in humans, and 8) profound species differences. Many aspects of fetal physiology can only be investigated with the use of invasive techniques. Obviously their use must be restricted to animal studies and, consequently, relatively little is known of the human fetus per se. Although one has to be careful in extrapolating animal data to man, animal studies provide a powerful tool in improving our understanding of human physiology. This thesis represents an effort to obtain a better understanding of the physiologic adaptations to the combined stresses of exercise and pregnancy. It consists of four chapters. Chapter one extensively reviews the literature, discussing the physiologic changes which occur both in pregnancy and exercise, as well as the adaptations to these combined stresses. Rather than to focus on the differences in experimental design and species we emphasize the common denominator in what is known and not known about the subject, and point out fertile topics for further investigation. Chapters two and three present the results of our experimental studies of acute maternal and fetal responses to exercise in chronically instrumented sheep. Finally, chapter four deals with the main physiologic changes during exercise in pregnanc

Thermodynamics of Nonstoichiometric Nickel Tellurides. I. Heat Capacity and Thermodynamic Functions of the δ Phase from 5 to 350°K

Heat capacities of the nickel tellurides were measured at compositions NiTe1.1 and NiTe2.0 (near limits of homogeneity of the δ phase) and at one intermediate composition, NiTe1.5, from 5 to 350°K. Heat capacity values and entropy and enthalpy increments are tabulated. No evidence of order‐disorder transitions, or thermal anomalies, or of contributions to the thermal properties from the anisotropy or phonon scattering by the holes in the structure on approaching the composition NiTe2 was observed. Although simple additivity of the heat capacities of the constituent elements failed to represent that of the solution compositions adequately, a Kopp‐Neumann treatment in terms of the limiting compositions of the δ phase gives good agreement with the experimental heat capacity and entropy of NiTe1.5 and hence is useful in interpolating to other intermediate compositions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/70090/2/JCPSA6-28-3-497-1.pd

Anisotropic Colossal Magnetoresistance Effects in Fe_{1-x}Cu_xCr_2S_4

A detailed study of the electronic transport and magnetic properties of Fe$_{1-x}$Cu$_x$Cr$_2$S$_4$ ($x \leq 0.5$) on single crystals is presented. The resistivity is investigated for $2 \leq T \leq 300$ K in magnetic fields up to 14 Tesla and under hydrostatic pressure up to 16 kbar. In addition magnetization and ferromagnetic resonance (FMR) measurements were performed. FMR and magnetization data reveal a pronounced magnetic anisotropy, which develops below the Curie temperature, $T_{\mathrm{C}}$, and increases strongly towards lower temperatures. Increasing the Cu concentration reduces this effect. At temperatures below 35 K the magnetoresistance, $MR = \frac{\rho(0) - \rho(H)}{\rho(0)}$, exhibits a strong dependence on the direction of the magnetic field, probably due to an enhanced anisotropy. Applying the field along the hard axis leads to a change of sign and a strong increase of the absolute value of the magnetoresistance. On the other hand the magnetoresistance remains positive down to lower temperatures, exhibiting a smeared out maximum with the magnetic field applied along the easy axis. The results are discussed in the ionic picture using a triple-exchange model for electron hopping as well as a half-metal utilizing a band picture.Comment: some typos correcte

A rare case of abnormal uterine bleeding caused by cavernous hemangioma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Cavernous hemangiomas of the uterus are extremely rare, benign lesions. A survey of the current literature identified fewer than 50 cases of hemangioma of the uterus.</p> <p>Case presentation</p> <p>We report a case of cavernous hemangioma of the uterus in a 27-year-old Malay, para 1 woman who presented at our hospital with torrential vaginal bleeding having been transferred by land ambulance from a district hospital 30 minutes away. 11 weeks previously she had an urgent cesarean section at our hospital. She had to undergo a hysterectomy to control her bleeding after other measures were unsuccessful. A histopathological report confirmed a diffuse ramifying hemangioma of the cervix and uterus with left hematosalpinx.</p> <p>Conclusion</p> <p>Most ramifying hemangioma lesions are asymptomatic and are found incidentally, but sometimes they may cause abnormal vaginal bleeding and hence should be included in the differential diagnosis of patients with vaginal bleeding. Hysterectomy is the primary mode of treatment in most symptomatic cases.</p

Haemorrhagia post partum; an implementation study on the evidence-based guideline of the Dutch Society of Obstetrics and Gynaecology (NVOG) and the MOET (Managing Obstetric Emergencies and Trauma-course) instructions; the Fluxim study

Contains fulltext : 88435.pdf (publisher's version ) (Open Access)BACKGROUND: One of the most important causes of maternal mortality and severe morbidity worldwide is post partum haemorrhage (PPH). Factors as substandard care are frequently reported in the international literature and there are similar reports in the Netherlands. The incidence of PPH in the Dutch population is 5% containing 10.000 women a year. The introduction of an evidence-based guideline on PPH by the Dutch society of Obstetrics and Gynaecology (NVOG) and the initiation of the MOET course (Managing Obstetrics Emergencies and Trauma) did not lead to a reduction of PPH. This implies the possibility of an incomplete implementation of both the NVOG guideline and MOET-instructions. Therefore, the aim of this study is to develop and test a tailored strategy to implement both the NVOG guideline and MOET-instructions METHODS/DESIGN: One step in the development procedure is to evaluate the implementation of the guideline and MOET-instructions in the current care. Therefore measurement of the actual care will be performed in a representative sample of 20 hospitals. This will be done by prospective observation of the third stage of labour of 320 women with a high risk of PPH using quality indicators extracted from the NVOG guideline and MOET instructions. In the next step barriers and facilitators for guideline adherence will be analyzed by performance of semi structured interviews with 30 professionals and 10 patients, followed by a questionnaire study among all Dutch gynaecologists and midwives to quantify the barriers mentioned. Based on the outcomes, a tailored strategy to implement the NVOG guideline and MOET-instructions will be developed and tested in a feasibility study in 4 hospitals, including effect-, process- and cost evaluation. DISCUSSION: This study will provide insight into current Dutch practice, in particular to what extent the PPH guidelines of the NVOG and the MOET-instructions have been implemented in the actual care, and into the barriers and facilitators regarding guideline adherence. The knowledge of the feasibility study regarding the effects and costs of the tailored strategy and the experiences of the users can be used in countries with a relatively high incidence of PPH. TRIAL REGISTRATION: ClinicTrials.gov NCT00928863